Measuring Calcium Intake Can Help To Identify Osteoporosis In Men With
Prostate Cancer
Main Category: Bones / Orthopaedics News
Article Date: 16 Apr 2007 - 1:00 PDT

Measuring a man's daily calcium intake is an effective way of identifying
prostate cancer patients with a higher than average risk of osteoporosis,
according to the April issue of the urology journal BJU International.

Researchers from the Autonoma University School of Medicine, Barcelona,
Spain, looked at a cross-section of 372 men with prostate cancer. 72 per
cent were receiving androgen-deprivation therapy (ADT) and 28 per cent had
undergone a radical prostatectomy. Their average age was just under 70.

They found that 49 per cent of the men had osteoporosis, including 55 per
cent of those who had received the ADT hormone therapy and 35 per cent of
those who had had a prostatectomy.

These figures are considerably higher than the prevalence of osteoporosis in
the general male population, where it's estimated that about 20 per cent of
all male osteoporosis cases occur in the 61 to 70 age group.

A dietary questionnaire revealed that only seven per cent of the men were
consuming more than 1000 mg of calcium a day - the average daily calcium
intake was 610mg in men with osteoporosis and 683mg in those without.

These levels are well below the 1000mg recommended for all 25-65 year-olds
by the US National Institutes of Health and the 1500mg recommended for men
over 65.

"Our research showed a significant relationship between a low daily calcium
intake and higher levels of osteoporosis in men with prostate cancer" says
lead researcher Dr Jacques Planas from the University's Department of
Urology.

"Men who had undergone ADT hormone therapy were particularly at risk and
longer treatment and increased age were also related to higher levels of
osteoporosis.

"What was particularly interesting was the fact that more than a third of
the patients who hadn't received hormone treatment also developed
osteoporosis."

Osteoporosis is caused by loss of bone mineral density, which makes bones
brittle and significantly more likely to fracture. It is more common in
older people and has been strongly linked to hormonal changes, such as the
female menopause.

Links to ADT hormone therapy have also been reported, but the Barcelona
study is thought to be the first to look at using daily calcium as a
diagnostic tool to identify prostate cancer patients who face an increased
risk of osteoporosis, including those who have not received ADT.

"Men account for about a third of all hip fractures, but they are much more
likely to die after an injury of this nature than women, so it is important
to identify possible risks at an early stage" adds Dr Planas.

Hormone treatment ranged from 12 to 98 months, with an average of just over
42 months. Men with bone disorders or secondary causes of osteoporosis were
excluded from the study.

As well as the dietary questionnaire, the men taking part in the study had
their bone mineral density measured at the lumbar spine and four different
hip sites in line with the guidelines developed by the International Society
for Clinical Densitometry for the diagnosis of osteoporosis.

"We carried out our research to discover whether there was a relationship
between low daily calcium intake and reduced bone mineral density, which
there clearly was" say Dr Planas.

"We also wanted to know if daily calcium intake could be used as a
prognostic factor for osteoporosis, especially for patients receiving ADT.
Our research suggests that it does provide a good pointer to whether a
prostate cancer patient also has osteoporosis."

The authors suggest that patients with prostate cancer should be routinely
advised to take at least 1000mg of calcium a day and that their bone mineral
density should be assessed, particularly before starting ADT, and monitored
at regular intervals after the treatment begins.

###

* The relationship between daily calcium intake and bone mineral density in
men with prostate cancer. Planas et al. BJU International. 99, pp 812-816.
(April 2007).

* Established in 1929, BJU International is published 12 times a year by
Blackwell Publishing and edited by Professor John Fitzpatrick from
University College Dublin, Ireland. It provides its international readership
with invaluable practical information on all aspects of urology, including
original and investigative articles and illustrated surgery.
http://www.bjui.org/

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Contact: Annette Whibley
Blackwell Publishing Ltd.